Provider Demographics
NPI:1497187322
Name:ROYER, NATHANIEL (DPT)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:ROYER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 E 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6900 E 47TH AVENUE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-3463
Practice Address - Country:US
Practice Address - Phone:303-920-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist